Richard Davis: Stick it to 'em

Posted
Wednesday, September 7, 2016 7:58 pm

Brattleboro Reformer

The recent revelation that pharmaceutical manufacturer Mylan is charging $600 for two pre-filled Epi-Pen syringes of epinephrine for use in allergic reaction emergencies is nothing new. Pharmaceutical pricing in this country has been unregulated and it is the Wild West when it comes to profits. They charge what they want and do not consider the life-threatening situations they create.

The case of Mylan is particularly horrific because they are selling a product that contains a substance that has been around for years. Their company has simply figured out a way to put epinephrine in a syringe that is easy to use and that will stay effective for up to a year. My best guess is that a package of two pre-filled syringes might cost Mylan $20 to produce, and that is probably being too generous to them.

Mylan did not have to do the type of research and development that is done for most other types of drugs yet they are showing no signs of remorse over being not only greedy but also being immoral. Without drug industry price regulation, greed will rule the day. One need only look at drug prices in countries that have decided that regulating prices is the right thing to do for their people.

In this particular case there is a way for people with serious allergies to bypass the Mylan option. It requires some effort and is not simple, but I believe most people could do it. A one dose vial of epinephrine costs about $5.

A single dose vial contains one cc of epinephrine and could be drawn up into an insulin syringe. A bulk purchase of syringes can bring the cost of one syringe to about 10 cents. In order for a person to be ready to self-inject quickly they would need to draw up the epinephrine and leave it in the syringe.

Epinephrine is light sensitive so the syringe needs to be kept in a case that does not let light in. My research has indicated that such a syringe would allow the epinephrine to be usable for about a month. That means that a person would have to have a refillable prescription and fill a new syringe every month.

Is it worth it or feasible for people to do this without being subjected to the immoral greed of the Mylan vultures? Consider the fact that the non-Mylan option would cost about $65 dollars a year compared to $300 for the same amount from Mylan.

When a person who relies on carrying epinephrine as a potential life-saver looks at the years they have to maintain that kind of protection they can consider the long-term cost of going it on their own. Over a 10-year period that person could save $2,350. I would rather keep that money in my pocket instead of helping a greedy drug company executive pay for a mortgage on his second or third vacation home.

Nurses who work in doctors' offices are a good source of teaching people how to fill syringes and this would be a valuable money saver not only for patients but for the entire health insurance industry. If enough people decided to use this option then perhaps they could put Mylan out of business (don't hold your breath).

Institutions that employ nurses, such as schools, should not be buying the Epi-Pens. Those nurses should be teaching students to prepare their own syringes or do it for them. In an August 29 column in the Boston Globe, Dante Ramos summed up the situation saying, "Even before Monday, the EpiPen was a textbook case of how to exploit the emotional, political, and economic factors that shape health care spending in the United States. Mylan had bought the patent for a familiar medical treatment and jacked up the price without substantially changing it; lobbied for federal and state legislation to make its product ubiquitous in schools and elsewhere; launched an aggressive marketing campaign — complete with $1.7 million in ads during the Rio Olympics — to terrify consumers about the risk of allergic reactions; and created a coupon program that would mollify consumers concerned about soaring co-pays while still allowing Mylan to squeeze more money out of insurers."

Ramos adds, "And now the company is also poised to preempt generic rivals and profit from risk-averse consumers' affinity for brand-name drugs. The scandal over the EpiPen ought to embarrass Bresch (Mylan CEO) and her company, but all those unsolicited testimonials to the device's life-saving capacity might just embolden them."

Richard Davis is a registered nurse. He writes from Guilford and welcomes comments at rbdav@comcast.net. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.

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